JENNA TAYLOR RUPLE (NPI# 1437418589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437418589 |
| Entity Type | Individual |
| Full Name | JENNA TAYLOR RUPLE |
| Credential | MD |
| Practice Address |
451 Health Pkwy Suite A Paw Paw MI 49079-8242 |
| Practice Telephone | 2696572550 |
| Practice Fax Number | 2696572285 |
| Mailing Telephone | 2696572550 |
| Mailing Fax Number | 2696572285 |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301108074 | MI | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01075489A | IN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 11016450A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | BCBS E BLAIR WARNER | 000000948449 | 01 |
| IN | 201112790 | 05 |
| Street Address |
451 HEALTH PKWY SUITE A |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079-8242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033115183 | Pamela Nelson | Family Medicine | 451 Health Pkwy, Suite B, Paw Paw, MI 49079-8242 | 2005-06-23 |
| 1972132256 | Jean Marie Brosnan | Registered Nurse | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2020-04-07 |
| 1114570801 | Kinju Dudhia | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-22 |
| 1235781345 | Marlesa Maria Johnson | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-10 |
| 1447802459 | Miranda Novak | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-07-10 |
| 1336709500 | Daniel E Laird | Physical Therapist | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2019-06-19 |
| 1932625043 | Debra Lynn Koning | Social Worker | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2017-08-21 |
| 1720439979 | Kimberly Baker | Social Worker | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2016-06-29 |
| 1467858118 | Sara Bailey | Nurse Practitioner | 451 Health Pkwy, Suite A, Paw Paw, MI 49079-8242 | 2014-11-07 |
| 1053729269 | Todd Super | Pharmacist | 451 Health Pkwy, Paw Paw, MI 49079 | 2014-07-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578090536 | Pamela Jean Blakemore Ray | Family Medicine | 451 Health Pkwy Ste F, Paw Paw, MI 49079-8242 | 2017-05-20 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1457469900 | Thomas Jerome Devlin | Family Medicine | 783 Winchester Street, Paw Paw, WV 25434-0002 | 2006-08-25 |
| 1205819356 | Lakeview Community Hospital | Family Medicine | 404 Hazen Street, Paw Paw, MI 49079-0178 | 2005-11-22 |
| 1033115183 | Pamela Nelson | Family Medicine | 451 Health Pkwy, Suite B, Paw Paw, MI 49079-8242 | 2005-06-23 |
| 1972966539 | Nilay Gandhi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2016-03-31 |
| 1770856932 | Pearce James Dupuis | Family Medicine | 451 Health Pkwy, Suite A, Paw Paw, MI 49079-8242 | 2012-02-20 |
| 1114128501 | Zebi Naz | Family Medicine | 451 Health Pkwy, Suite A, Paw Paw, MI 49079-8242 | 2007-05-31 |
| 1851466817 | Star Health Multispecialty Group P.C. | Family Medicine | 451 Health Pkwy, Paw Paw, MI 49079-8242 | 2006-11-22 |
| 1972585115 | Vincent R Cabras | Family Medicine | 451 Health Pkwy, Suite B, Paw Paw, MI 49079-8242 | 2005-11-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.